Evaluation of hypoxia-inducible factor-1 alpha, vascularendothelial growth factor, tumor necrosis factor-alpha, and matrix metalloproteinase-9 levels in pulp tissue samples of healthy teeth and teeth diagnosed with symptomatic irreversible pulpitis

Objective: Local measurement of biomarkers in the pulp may aid in distinguishing different stages of inflammation and improve the predictive accuracy of pulpal diagnoses. This study aimed to evaluate the levels of MMP-9, VEGF-α, TNF-α, and HIF-1α in pulpal blood samples obtained from healthy teeth and teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The study included a total of 50 patients (25 female, 25 male) aged between 18 and 50 years. Of these, 25 had teeth diagnosed with symptomatic irreversible pulpitis (pulpitis group), while the remaining 25 had healthy teeth (control group). Teeth in the control group were either third molars indicated for extraction or teeth requiring preprosthetic root canal treatment. All treatment procedures and pulpal blood sampling were performed under local anesthesia with rubber dam isolation. After pulpal access in both groups, blood samples were collected using paper points and transferred into sterile eppendorf tubes. Samples were stored at –80 °C in an ultra-low temperature freezer until analysis by ELISA. For statistical evaluation, the Independent Samples t-test was used to compare the two groups. Results: Compared to the control group, significantly elevated TNF-α levels were observed in the pulpitis group (p < 0.05). However, no significant differences were found between groups in VEGF-α, MMP-9, or HIF-1α levels (p > 0.05).